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9_ronmentalSAN-JOAQUIN RECE!!� Health Department <br /> i ---COUNTY MAY 0 S 20le PUBJIC RECORDS RELEASE APPLICATION <br /> 5, Qr%tt I;nr �0 <br /> ryEWR <br /> �IL <br /> • PEt�MIT EHD LOG NUMBER: 8f3-7;L!; <br /> APPLICANT: Jackie Hyman BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 3335 East Miraloma Avenue#142 CITY/STATE/ZIP:Anaheim,CA 92806 <br /> PHONE(1): 800-511-9300 PHONE(2): FAX OR E-MAIL: jhyman@advgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact to rrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 08 Nla%2018 <br /> 1. List up to ten addresses in the ce low. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate ox(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to info(d)sicehd com Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Ir <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. (p <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From June 2017 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ONLY <br /> 0 Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) Q QQ CONSUMER <br /> QOther Cleanup Site(Non-LOP) 1 881 Shaw Road Stockton ���� ev/sP ❑ <br /> • ❑X Hazardous Waste <br /> ❑DAIRY <br /> FX Tiered Permitted Facility 2 <br /> Q Aboveground Tank <br /> QX UST (Monitoring/Removal) ❑PWS <br /> 0 Hazardous Materials s <br /> Q Spill/Release Response <br /> Q Solid Waste Facility/Vehicle 4 [9WATER QUALITY <br /> F]Food Facility <br /> F Pool/Spa SITE MMGA11ON <br /> Dairy 6 <br /> Land Use Application Sites <br /> Septic Pumper Truck/ 6 11HOUSING <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST/HM/HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel SJCUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> SOLID WASTE <br /> Waste Tire g <br /> ❑Complaint <br /> E]Other(Please Specify): ❑AccouNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> U . V k V <br /> ❑ Records provided by Staff-PPR Complete. Starr Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.coin <br />